hospitalization coverage under medicare

[annamom]

I am in a hospital and chances are that I may stay for a total of 10 days (I will be okay)
I looked into Medicare coverage for a hospital stay. If I understand correctly it is 60 days, then $335 for the next 30 days, and around $670 for the next 60 days.
But it is a lifetime coverage. Initially, I thought it is a lot, but given I used up 10 days for something I thought is minor, therefore, I am concerned that I can easily use up all the covered day.
My question is how do people normally “extend” the coverage? do people buy extra coverage?

[thumper1]

What are you talking about? Could you please site a reference for a lifetime limit on hospital stays using Medicare?

[HImom]

A lot of folks have MediGap or a supplement. It may cover what Medicare doesn’t.

[thumper1]

This is for each benefit period…a benefit period is defined as…

The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you’re admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven’t gotten any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There’s no limit to the number of benefit periods.

@annamom

[thumper1]

@HImom as you know…the medigap policies can help with the difference between what Medicare pays…and doesn’t pay…and those benefits are defined by the medigap policy one gets.

But I believe @annamom might have misinterpreted what she was reading. It’s important to understand what a “benefit period” is.

And as noted in the quote above…there is NO limit to the number of benefit periods.

@annamom do you have a medigap policy?

[thumper1]

@“Cardinal Fang” @calmom

Am I missing something here?

[annamom]

I have supplement
Yes. I read that as lifetime
Thanks for pointing out that there is no limit to the number of benefit period

[twoinanddone]

My father was in hospitals multiple times over his 20 years on medicare. There is no lifetime maximum. There are some limits on rehab/nursing care stays, but those can be extended if medically necessary.

His last hospital stay was almost 21 days and we keep getting bills for ~$50k, with his ‘responsibility’ $1000.

[calmom]

@thumper1 I don’t have time to check actual regs right now, but I know from experience that my 93 year old father and 80+ step-mom have been hospitalized way more than 6o days off and on over the years and Medicare kept paying. My dad’s Medicare only ran out this year after he was hospitalized continuously for 60 days, and on day 61 he was moved to a long term care facility. Medicare does not pay for LTC but he does have a LTC policy, and Medicare will still cover a lot, such as outpatient doctor visits or physical therapy. (My dad is not going to get better, but LTC really is more appropriate to his needs at this point.)

I do know that he also has a plan F Medigap policy.

[calmom]

OK now I looked it up in the handy Medicare & You book that the government so kindly sent me.

I think that @annamom was probably looking at the lifetime reserve days provision, which is an added tack on benefit.

Medicare pays:
During each “benefit period”:

[QUOTE=""]

60 days of hospitalization with $1364 deductible and no coinsurance
An additional 30 days (so up to 90 days) within the same benefit period, with a coinsurance amount of $341/day (which could be $10,230 out of pocket).

[/QUOTE]

There are also 60 days of “lifetime reserve” that can be used to cover anything past the 90 days, with a coinsurance of $682 (so potentially another $20,460) – and that is what will run out.

A Medicare gap policy B, C, D, F, G or N would cover all those coinsurance & deductible amounts, plus up to 365 days of hospital costs beyond what Medicare pays. (The +365 would be lifetime benefits) Chart here: https://boomerbenefits.com/medicare-supplemental-insurance/medigap-comparison-chart/

“Benefit period” is

A benefit period begins the day you’re admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven’t gotten any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There’s no limit to the number of benefit periods.

See https://www.medicare.gov/node/32116

So basically annamom’s 10 day stay now isn’t going to count against any future hospital stays as long as it is more than 60 days between the current stay and any future stay.

As to my comments above about my dad, it was probably day 91 rather than 61 that he was moved – but hard for me to track as he has was hospitalized in late October and hasn’t been able to return home since, and I don’t think it had been 60 days since his most recent hospitalization before that. And I’m not the one keeping track. (If my stepmom called and asked for my help, I’d be on it – but I think they have plenty of local resources to figure out the ins & outs of medicare & other insurances).